CMS Formulary

Displaying 93911-93920 of 1611142 results.
ID: 93911
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1368459
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93912
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 751970
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93913
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 836358
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 312
Qty Limit Days: 30
ID: 93914
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191250
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93915
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 207373
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93916
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245268
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 93917
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 314088
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93918
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 403914
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93919
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 885209
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 93920
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1922765
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0